EP0577038B1 - Intravascular blood parameter sensing system - Google Patents
Intravascular blood parameter sensing system Download PDFInfo
- Publication number
- EP0577038B1 EP0577038B1 EP93110258A EP93110258A EP0577038B1 EP 0577038 B1 EP0577038 B1 EP 0577038B1 EP 93110258 A EP93110258 A EP 93110258A EP 93110258 A EP93110258 A EP 93110258A EP 0577038 B1 EP0577038 B1 EP 0577038B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- blood
- assembly
- lumen
- volume
- sensing element
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
- A61B5/1459—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters invasive, e.g. introduced into the body by a catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/15—Devices for taking samples of blood
- A61B5/150007—Details
- A61B5/150015—Source of blood
- A61B5/15003—Source of blood for venous or arterial blood
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/15—Devices for taking samples of blood
- A61B5/150007—Details
- A61B5/150206—Construction or design features not otherwise provided for; manufacturing or production; packages; sterilisation of piercing element, piercing device or sampling device
- A61B5/150221—Valves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/15—Devices for taking samples of blood
- A61B5/150992—Blood sampling from a fluid line external to a patient, such as a catheter line, combined with an infusion line; blood sampling from indwelling needle sets, e.g. sealable ports, luer couplings, valves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/15—Devices for taking samples of blood
- A61B5/155—Devices specially adapted for continuous or multiple sampling, e.g. at predetermined intervals
Definitions
- the sensing element can be easily calibrated using a one point system, that is calibrating the sensing element based upon the known volume of the parameter of interest in the non-blood-containing fluid medium, e.g., pure flush solution. Since, with the volume oscillator inactive, the sensing element is preferably exposed substantially exclusively to the flush solution, which preferably includes an anti-clotting component such as heparin, the tendency to thrombus formation at or near the distal tip of the probe is reduced.
- the flush solution which preferably includes an anti-clotting component such as heparin
- the probe may carry one or more sensing elements depending upon the number of parameters of interest.
- These sensing elements can be of any type, such as electro-chemical, that is suitable for sensing the parameter of interest; however, optical sensing elements are preferred, and fluorescent sensing elements are considered optimum. Although multiple sensing elements could be provided to sense the same blood parameter, preferably, each sensing element senses a different blood parameter.
- the transmission member includes an optical fiber for each of the sensing elements, with the sensing element being located on the distal end of the associated optical fiber.
- the sensing elements provide signals related to the associated blood parameters of interest, and such signals may be used or processed continuously, intermittently or on demand, preferably continuously while the volume oscillator is activated, to provide readings indicative of the blood parameters of interest.
- the probe-catheter assembly 15 includes a catheter 53 and a probe 55 (Fig. 3).
- the catheter 53 may be a conventional arterial catheter.
- the catheter 53 may include a proximal end 57, a distal end 59, a lumen 61 extending axially, completely through the catheter and opening at a distal opening 63 at the distal end.
- the catheter 53 has a standard lead-in taper, i.e., a tapered zone 65, which extends from a reference plane 66 along the outer periphery of the catheter 53 to the distal end 59.
- the diameter of the lumen 61 also decreases distally throughout the tapered zone 65 as shown in Fig. 2.
- the catheter 53 has an externally threaded coupling 67 at its proximal end.
- the probe 55 includes a "Y" fitting 93 at its proximal end as shown in Fig. 3.
- the optical fibers 75, 77 and 79 extend within the sheath 87 completely through one leg 95 of the "Y" fitting 93 to the instrument 17, as shown in Fig. 1.
- Another leg 97 of the fitting 93 has a passage 99 which communicates with the lumen 61, and more particularly, with the clearance 81 around the probe 55.
- the leg 97 is coupled to the conduit 21 of the system 13 as shown in Fig. 1.
- a third leg 101 of the "y" fitting 93 carries a rotatable internally threaded coupling 103 for attaching the "y" fitting of the probe 55 to the proximal end 57 of the catheter 53 outside the cardiovascular system of the patient.
- the sheath 87 may be guided in the leg 95 by a sleeve 105 and retained in position by potting 107.
- the sheath 87 extends within a flexible tube 109 suitably attached to the leg 95, and shrink tubing 111 is provided over the adjacent end portions of the fitting and the tube for strain relief.
- O-ring seal 163 is positioned to keep the flow path 153 and chamber 170 hermetically sealed.
- O-ring seal 165 is positioned so that any fluid spills are prevented from contacting the motor 157.
- Housing 123 and piston stem 125 are disposable, for example, after use with a single patient, while holder 121 (and the other components of volume oscillator 29) are used repeatedly with many patients. Since no blood comes into contact with the holder 121, there is no cross contamination between patients.
- Housing 123 and piston end surface 127 together form an open ended generally cylindrically shaped chamber 170 the volume of which varies depending on the position of surface 127. When volume oscillator 29 is inactive, the volume of chamber 170 is substantially zero.
- Fig. 5 schematically illustrates how the movement of piston stem 125 is controlled.
- Control module 179 is in electrical communication, through conduit 181, with microprocessor 177, which can be of conventional design.
- Information for example, the amount of time the piston stem 125 is to take to move through one complete cycle (the cycle time) and whether the volume oscillator 29 is to be continuously or intermittently active, is manually inputed into microprocessor 177 through control module 179, for example, through a series of touch keys, switches and the like on the control module.
- Microprocessor 177 processes this input in accordance with one or more relationships, for example, the wave form through which piston stem 125 is to move in one complete cycle, previously programmed into the microprocessor.
- Control instructions, in the form of electrical signals, are then given by microprocessor 177 to motor control (or micro-step electronics) 173 through conduit 183 which, in turn, controls the action of motor 157 and the movement of piston stem 125.
- the blood pressure monitored by pressure transducer 31 is substantially unaffected by the action of the volume oscillator 29, particularly during the above-noted seven second period. Further, because of the relatively smooth functioning of stepping motor 157, even with blood being moved into and out of lumen 61, the blood pressure measurements of pressure transducer 131 are relatively unaffected by the volume oscillator 29.
Description
Claims (19)
- An assembly for the sensing of a blood parameter comprising:a sensing element (69, 71, 73) for sensing a parameter of blood and providing a signal in response thereto, and an elongated transmission member (75, 77, 79) for transmitting said signal from said sensing element:a catheter (53) having a proximal end (57), a distal end (59) and a lumen (61) extending therethrough, said lumen having an opening (63) in said distal end, said catheter being sized and adapted so that at least said distal end and said opening are receivable within a blood vessel of a patient, said sensing element being located within said lumen, said catheter being configured such that said catheter is capable of being connected to a flush solution source so as to allow for the introduction of flush solution into said lumen:a volume oscillator (29) in fluid communication with said lumen, said volume oscillator being adapted to periodically cause blood from the blood vessel of the patient to move into and out of said lumen such that said sensing element is exposed to substantially exclusively blood for a portion of the time said volume oscillator is activated and to substantially exclusively said flush solution for another portion of the time said volume oscillator is activated,
characterised in thatsaid volume oscillator (29) defining a chamber (170) of variable volume and means for varying the fluid volume of said chamber in accordance with a waveform going through four phases, wherein in the first phase the volume of chamber (170) is rapidly increased to expose the sensing element (69, 71, 73) to substantially exclusively blood, in the second phase the volume is more slowly increased so as to maintain a constant volume of the substantially exclusively blood in the lumen (61), in the third phase the volume is rapidly decreased to expel the blood from the lumen (61), and in the fourth phase the volume is decreased more rapidly so as to expel the flush solution; and means (17) for calculating the value of said blood parameter based upon both the values sensed by said sensing element when exposed to substantially exclusively blood and when exposed to substantially exclusively said flush solution. - The assembly of claim 1 wherein said sensing element (69, 71, 73) is located at least 4 mm proximal of said opening (63).
- The assembly of claim 1 or 2 wherein said sensing element (69, 71, 73) is located at least 6 mm proximal of said opening (63).
- The assembly of any of claims 1 to 3 wherein said sensing element (69, 71, 73) is located up to 40 mm proximal of said opening (63).
- The assembly of any of claims 1 to 3 wherein said sensing element (69, 71, 73) is located up to 20 mm proximal of said opening (63).
- The assembly of any of the preceding claims wherein said sensing element (69, 71, 73) is adapted for sensing carbon dioxide.
- The assembly of any of the preceding claims wherein said sensing element (69, 71, 73) is adapted for sensing oxygen.
- The assembly of any of the preceding claims wherein said assembly comprises a probe (55) including said sensing element and said probe (55) has a longitudinal axis and an average diameter within said lumen (61) perpendicular to said longitudinal axis of about 0.56 mm or less.
- The assembly of any of the preceding claims wherein said volume oscillator (29) is preprogrammed to periodically cause blood to enter said lumen (61) and to exit said lumen in a predetermined time sequence.
- The assembly of any of the preceding claims wherein said volume oscillator (29) includes a housing (123) and a piston, which are adapted to be disposed of after use with a single patient, and an actuator (156, 157, 173, 175, 177, 179, 181, 183) adapted to be removably coupled to said piston.
- The assembly of any of the preceding claims wherein said volume oscillator (29) comprises:a housing (123) defining a fluid flow path in fluid communication with said lumen (61) and capable of being placed in fluid communication with said flush solution;a piston moveable relative to said housing and together with said housing defining a chamber of variable volume, said chamber being in fluid communication with said fluid flow path;a stem (125) secured to said piston and adapted to be activated to move said piston relative to said housing to thereby vary the volume of said chamber; andmeans (156, 157, 173, 175, 177, 179, 181, 183) for activating said stem in predetermined time sequence so that the volume of said chamber varies with time in accordance with a wave form.
- The assembly of claim 11 wherein said wave form is such that the amount of blood in said lumen (61) is maintained substantially constant for a portion of the time said stem (125) is activated.
- The assembly of claim 11 wherein said wave form is such that the amount of blood in said lumen (61) is maintained substantially constant for a major portion of the time said stem (125) is activated.
- The assembly of any of claims 10 to 13 wherein said activating means comprises an actuator removably coupled to said stem (125) and wherein said housing (123), piston, and stem (125) are separable from said assembly such that they can be disposed of after use with a single patient.
- The assembly of any of claims 10 to 14 wherein said actuator includes a motor (156) with a motor shaft (157) which is removably coupled to said stem (125), and a control system (173, 175, 177, 179, 181, 183) in electrical communication with said motor (157) to provide control information to said motor to control said motor, and thereby control the time sequence in which said stem is activated.
- The assembly of claim 15 wherein said control system includes a microprocessor (177) adapted to be preprogrammed to provide said control information.
- The assembly of claim 15 or 16 wherein said motor (157) is a stepping motor (157) and said control system is adapted to control said motor to at least reduce the magnitude of the individual steps taken by said motor.
- The assembly of any of claims 10 to 14 further comprising a holder (121) which carries said housing (123) and at least a portion of said actuator.
- The assembly of claim 18 wherein said holder (121) includes a cavity (129) which receives and holds said housing, and said holder and said housing include first and second positioning elements (145, 147), respectively, which are adapted to be mutually engaged to hold said housing in said cavity.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US906740 | 1992-06-29 | ||
US07/906,740 US5335658A (en) | 1992-06-29 | 1992-06-29 | Intravascular blood parameter sensing system |
Publications (2)
Publication Number | Publication Date |
---|---|
EP0577038A1 EP0577038A1 (en) | 1994-01-05 |
EP0577038B1 true EP0577038B1 (en) | 1999-01-07 |
Family
ID=25422902
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP93110258A Expired - Lifetime EP0577038B1 (en) | 1992-06-29 | 1993-06-28 | Intravascular blood parameter sensing system |
Country Status (5)
Country | Link |
---|---|
US (2) | US5335658A (en) |
EP (1) | EP0577038B1 (en) |
JP (1) | JPH0670917A (en) |
CA (1) | CA2099300A1 (en) |
DE (1) | DE69322906T2 (en) |
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-
1992
- 1992-06-29 US US07/906,740 patent/US5335658A/en not_active Expired - Fee Related
-
1993
- 1993-06-24 JP JP5153397A patent/JPH0670917A/en active Pending
- 1993-06-28 EP EP93110258A patent/EP0577038B1/en not_active Expired - Lifetime
- 1993-06-28 CA CA002099300A patent/CA2099300A1/en not_active Abandoned
- 1993-06-28 DE DE69322906T patent/DE69322906T2/en not_active Expired - Fee Related
-
1994
- 1994-05-20 US US08/247,025 patent/US5421328A/en not_active Expired - Fee Related
Also Published As
Publication number | Publication date |
---|---|
EP0577038A1 (en) | 1994-01-05 |
US5421328A (en) | 1995-06-06 |
JPH0670917A (en) | 1994-03-15 |
US5335658A (en) | 1994-08-09 |
DE69322906T2 (en) | 1999-09-23 |
CA2099300A1 (en) | 1993-12-30 |
DE69322906D1 (en) | 1999-02-18 |
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